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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Mar 21, 2026; 32(11): 115723
Published online Mar 21, 2026. doi: 10.3748/wjg.v32.i11.115723
Toward noninvasive prediction of treatment outcomes in patients with variceal bleeding
Fernanda M Martínez-Díaz, Elsie A Jiménez-Cuevas, Arnulfo E Morales-Galicia, Mariana M Ramírez-Mejía, Xing-Shun Qi, Jorge L Poo, Nahum Méndez-Sánchez
Fernanda M Martínez-Díaz, Elsie A Jiménez-Cuevas, Nahum Méndez-Sánchez, Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City 14050, Mexico
Arnulfo E Morales-Galicia, Mariana M Ramírez-Mejía, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04360, Mexico
Xing-Shun Qi, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
Jorge L Poo, Centro de Innovación y Educación Ejecutiva, Tecnológico de Monterrey, Mexico City 14380, Mexico
Author contributions: Méndez-Sánchez N, Martínez-Díaz FM, Jiménez-Cuevas EA, Morales-Galicia AE, Ramírez-Mejía MM, Qi XS, and Poo JL contributed to this paper; Méndez-Sánchez N designed the overall concept and outline of the manuscript; Martínez-Díaz FM, Jiménez-Cuevas EA, Morales-Galicia AE, and Ramírez-Mejía MM contributed to the discussion and design of the manuscript; Méndez-Sánchez N, Martínez-Díaz FM, Jiménez-Cuevas EA, Morales-Galicia AE, Ramírez-Mejía MM, Qi XS, and Poo JL contributed to the writing and editing of the manuscript, illustrations, and literature review. All authors approved the final version to publish.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Nahum Méndez-Sánchez, MD, MSc, PhD, Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Colonia Toriello Guerra, Mexico City 14050, Mexico. nmendez@medicasur.org.mx
Received: October 24, 2025
Revised: December 17, 2025
Accepted: January 20, 2026
Published online: March 21, 2026
Processing time: 143 Days and 8.5 Hours
Core Tip

Core Tip: Esophageal variceal bleeding represents one of the most lethal complications of cirrhosis, with high rebleeding and mortality rates despite standard therapy involving endoscopic variceal band ligation. Current follow-up strategies rely on repeated endoscopy and hepatic venous pressure gradient measurements, which are both invasive and resource intensive, whereas noninvasive tools such as elastography and the Baveno criteria lack validation for predicting post-endoscopic variceal band ligation outcomes. Multiparametric ultrasound, by integrating measurement of liver and spleen stiffness with perfusion imaging, offers a comprehensive, noninvasive assessment of portal hypertension and may enable individualized follow-up, reduce procedural burden, and improve patient-centered care.